The Alveolar Ridge Splitting Technique on Maxillae: A Biomechanical Human Cadaveric Investigation

Area of Science:

• Oral and Maxillofacial Surgery
• Biomaterials Science
• Dental Implantology

Background:

• Alveolar ridge splitting technique (ARST) is an alternative for dental implant insertion.
• Fracture of the buccal lamella is a risk during ARST distraction.
• Understanding fracture mechanisms is crucial for ARST optimization.

Purpose of the Study:

• To investigate the biomechanical properties and fracture limits of the buccal lamella during ARST.
• To evaluate the influence of split geometry on lamella failure.
• To inform surgical planning for ARST.

Main Methods:

• Biomechanical testing of 12 human cadaveric maxilla specimens with atrophied ridges.
• Standardized alveolar splits created using an oscillating piezoelectric saw.
• Failure testing using a dental osteotome and electromechanical testing system.
• High-resolution peripheral quantitative computed tomography (HPQCT) for pre- and post-testing analysis.

Main Results:

• Split stiffness, failure force, and displacement were measured (27.4 N/mm, 12.0 N, 0.97 mm, respectively).
• No significant differences in biomechanical outcomes were found between anatomical sides or split locations (p ≥ 0.17).
• Stiffness significantly correlated with failure force (R² = 0.71, p < 0.01), but split width did not predict failure (p ≥ 0.10).

Conclusions:

• Simple geometric measurements are insufficient for predicting buccal lamella distraction limits in ARST.
• Sophisticated methods are needed for surgical planning to enhance ARST outcomes.
• A clinical protocol involving immediate implant site preparation after osteotomy may minimize bone loss and mechanical stress.